Prevalence and Antibiotic Resistance of Clostridioides (Clostridium difficile) In Meat and Meat Products: A Systematic Review and Meta-Analysis

Zahra Esfandiari; Parisa Shoaei; Bahareh Vakili; Ziba Farajzadegan; Mohammad Javad Tarrahi; Zahra Emami; Yadolah Fakhri; J Scott Weese; Trias Mahmudiono

doi:10.18502/ijph.v52i12.14313

Prevalence and Antibiotic Resistance of Clostridioides (Clostridium difficile) In Meat and Meat Products: A Systematic Review and Meta-Analysis

Iran J Public Health. 2023 Dec;52(12):2516-2527. doi: 10.18502/ijph.v52i12.14313.

Authors

Zahra Esfandiari¹, Parisa Shoaei², Bahareh Vakili³, Ziba Farajzadegan⁴, Mohammad Javad Tarrahi⁵, Zahra Emami⁶, Yadolah Fakhri⁷, J Scott Weese⁸, Trias Mahmudiono⁹

Affiliations

¹ Nutrition and Food Security Research Center, Department of Food Science and Technology, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
² Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
⁴ Community and Preventive Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ Epidemiology Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
⁶ Department of Food Science and Technology, College of Agriculture, Isfahan University of Technology, Isfahan, Iran.
⁷ Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
⁸ Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
⁹ Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.

Abstract

Background: Meat and meat products are introduced as one of the frequent sources of Clostridioides difficile. We aimed to determine the prevalence and antibiotic resistance of C. difficile isolates in meat and meat products using a systematic review and meta-analysis.

Methods: A literature search was performed in the primary international and bibliographic databases such as MEDLINE (PubMed), Cochrane Library, Embase, Scopus, and Web of Science to achieve all articles related to the prevalence and antibiotic resistance rates from 2007 to 2022.

Results: The 278 retrieved articles were reduced to 54 worldwide eligible studies after screening and matching inclusion/exclusion criteria. C. difficile was examined in different types of samples and its resistance to 10 antibiotics. The pooled prevalence of C. difficile was 3.4% in all samples. C. difficile pooled prevalence was detected in fish, poultry, and red meat groups with 6.9%, 5.2%, and 3.2%, respectively. Regarding antibiotic resistance, the highest pooled prevalence was for ciprofloxacin (86.6%), followed by clindamycin (42.6%) and erythromycin (34%). The lowest pooled prevalence was observed in metronidazole (7.6%), vancomycin (6.6%), and chloramphenicol (6%).

Conclusion: Low resistance was found to commonly used drugs for C. difficile infection (CDI) treatment. Since each antibiotic can be predisposing cause for CDI development, this finding possibly will be warning from a One Health viewpoint about the misuse of antibiotics in the chain of farm to fork including agriculture, animal husbandry and the food industry and also their injudicious use in medicine.

Keywords: Antibiotic resistance; Clostridioides difficile; Meat; Meta-analysis; Systematic review.

Publication types

Review